Saturday, April 27, 2019

Medical Standard of Care 

The medical "Standard of Care" is a moving target, a gaseous cloud.

It is an indefinable and unpublished definition.  It is a concept that was developed by trial lawyers for medical malpractice law suits.   Unfortunately, doctors now must address the patient’s needs for medical care within the confines of this shadowy framework or be attacked by their state medical board if they try to “THINK OUTSIDE THE BOX.”


Those who define the standard are often not experts in the field. For example, state medical boards are made up of medical doctors, chiropractors, osteopathic physicians, podiatrists and even non-medically trained community active "civilians."  Now, I may be naive, but why would anyone think a chiropractor or "civilian" could properly judge the quality of medical care provided by an endocrinologist, pediatrician, neurosurgeon or any other highly specialized medical practitioner?  (For that matter, why would any one think a medical doctor should sit in judgment of a chiropractor?)

To make matters worse, state legislatures attempt to apply law to medical care!  State law governing medical care is an attempt to apply a static solution to a fluid situation.  A law has to be clearly defined to be enforceable.  A citizen must be able to read the law and know what is legal and what is not.  Since medicine is constantly changing, state law will always lag behind the state of the art in medical advancement or the law will have to be vaguely worded. Kansas statutes, (the state I am most familiar with), empowers the state board to enforce a medical standard of care “As determined by the board.”  Doctors in Kansas have been censured, suspended or even had their license revoked because the state board concluded that widely accepted medical practices were “Below the standard of care.”

Often medical boards will use only one doctor’s opinion to establish “their” meaning of standard of care.  Never mind that the medical care practiced by the doctor under assault is leading edge medicine and the exact care needed by that particular patient, the lawyers and agenda driven doctors at the state board are going to take the doctor down for contravention of state law!  It’s wrong and if doctors continue to allow the abuse it will only get worse.  Doctors work hard to achieve the status of Doctor of Medicine.  Their life is often destroyed because they got on the wrong side of a medical board, even though their knowledge and treatment of patients was cutting edge medicine.  I recently had a colonoscopy.  The only thing my doctor knew about the State Board of Healing Arts is that they sign his license to practice.  He was shocked when I told him the stories of abuse of doctors by the Medical Board.

Vague laws give state boards power beyond the mandate to “Protect the health and safety of the citizens.”  Many state medical boards launch witch hunts, are in the pocket of the drug companies and/or medical insurance companies.  One doctor told me, “Any doctor who is not a pimp for the insurance company and a whore for the pharmaceutical company will find himself in trouble with the State Board.”  Unfortunately, that moving target, the standard of care, is being used to destroy some of the best doctors in the country.

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